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Z 0 & N of e No.1 Fr Mr. AMERICAN RED CROSS NURSING SERVICE APPLICATION FOR ENROLLMENT (To be filled out entirely in applicant's handwriting) 2. Address in full A Manjin Hospital Phila., Pa 1. Name of applicant Francis gaps Lundy 30 3. Date of birth any 2/1/880 Place of birth Begant Ireland 4. Are you married, single, widow? Singly or a 5. Are you a citizen of the United States? lawe to Americal L&.8.4 ? No. S u Service Application 6. Have you any physical defects? naturalined 1891 7. Education and occupation before entering Training School Attended Conner 5 18yr. School Thy ustil 1.7 yrs. vle, General Braning School's 8. From what Training Phila, Pa. School did you graduate? A. Agnee Hospital 9. Character of hospital General ? year Special ? Nennes Seina Private? Roome IT) 10. How many beds in hospital at time of graduation? 18001 11. Date of graduation Jack 1.4, 1901 Length of course 3yrs 12. Name and address of Superintendent of Training School under whom you were trained Litera M. Maura, It Agres: Hospital, Philas.,Pa 13. Of whatpnursing organizationare you a member? 14. Give name and address of Secretary. Pecelia Hund. of Agnei strappy Phila A. Agrees. Hospitally Plummae 15. Are you a registered nurse? jes application In what mate State? Fom615 - ready - Pa. to forward Date of registration 16. How and where have you been employed since graduation? Give information for each year Nor.22 1901, organized A. Manjo Hospital Seaging school - Directrics of nursee Enter sincem. same School 17. Name and permanent address, of nearest relative games Secretary fasher) Hammiletton, Pal. Date. May 51111 Signature (Form Nos. 3 and 4), to the Chairman National Committtee on Red Cross Nursing Service, Washington, D.C. This blank to be sent to applicant with circular letter and rules governing enrollment. After approval and endorsement by local Committee to be forwarded with "credentials" a & 2

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53
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    "ocrText": "Z 0\n&\nN\nof\ne\nNo.1\nFr\nMr.\nAMERICAN RED CROSS\nNURSING SERVICE\nAPPLICATION FOR ENROLLMENT\n(To be filled out entirely in applicant's handwriting)\n2. Address in full A Manjin Hospital Phila., Pa\n1. Name of applicant Francis gaps Lundy\n30\n3. Date of birth any 2/1/880 Place of birth Begant Ireland\n4. Are you married, single, widow? Singly\nor a\n5. Are you a citizen of the United States?\nlawe to Americal L&.8.4\n?\nNo.\nS\nu Service Application\n6. Have you any physical defects?\nnaturalined 1891\n7. Education and occupation before entering Training School Attended Conner\n5\n18yr.\nSchool Thy ustil 1.7 yrs. vle, General Braning School's\n8. From what Training\nPhila, Pa.\nSchool did you graduate? A. Agnee Hospital\n9. Character of hospital General ? year\nSpecial ? Nennes Seina Private? Roome\nIT)\n10. How many beds in hospital at time of graduation?\n18001\n11. Date of graduation Jack 1.4, 1901 Length of course\n3yrs\n12. Name and address of Superintendent of Training School under whom you were trained\nLitera M. Maura, It Agres: Hospital, Philas.,Pa\n13. Of whatpnursing organizationare you a member?\n14.\nGive name and address of Secretary. Pecelia Hund. of Agnei strappy Phila\nA. Agrees. Hospitally Plummae\n15.\nAre you a registered nurse? jes application In what mate State? Fom615 - ready - Pa. to forward Date of registration\n16. How and where have you been employed since graduation? Give information for each year\nNor.22 1901, organized A. Manjo Hospital Seaging\nschool - Directrics of nursee Enter sincem. same School\n17. Name and permanent\naddress, of nearest relative games Secretary fasher)\nHammiletton, Pal.\nDate. May 51111\nSignature\n(Form Nos. 3 and 4), to the Chairman National Committtee on Red Cross Nursing Service, Washington, D.C.\nThis blank to be sent to applicant with circular letter and rules governing enrollment. After approval and endorsement by local Committee to be forwarded with \"credentials\"\na\n&\n2"
}